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REGULATION MEDICINE AND NEURAL THERAPY APPROACH TO POSTTRAUMATIC STRESS DISORDER (PTSD)

Ömer Soyak1,3, Ferda Firdin2,3, Hüseyin Nazlikul3,4,5

1 Freelance Physician, Samsun, Turkey

2 Freelance Physician, Bursa, Turkey

3 Scientific Neural Therapy and Regulation Association, Istanbul, Turkey

4 Naturel Sağlık - Natural Health Center, Istanbul, Turkey

5 Internatinal Federation Medical Associations of Neuraltherapy, Meiringen, Switzerland

This year, when we are eager to celebrate the 100th anniversary of our Republic, which was founded by Mustafa Kemal Atatürk and his friends with great efforts, and at a time when we, as neural therapists, are breathlessly continuing the preparations for the 9th International Neural Therapy Congress, which we will hold in Istanbul on June 2-4, 2023, we have experienced and are still experiencing a great earthquake disaster that has destroyed a part of our country and has so far caused the death of more than 50 thousand people and the number of people under the collapse is said to be well over 200 thousand.

Even watching what is happening in our earthquake-ravaged geography from afar makes it difficult to breathe and shocks people.

The intensity of the earthquake centered in Pazarcık and Elbistan (7.7, 7.6), the size of the region it affected, the destruction and losses it caused, the aftershocks that continued for a long time, the delayed rescue efforts, the problems such as shelter faced by the earthquake victims, have made the impact of this disaster much higher than the impact of previous disasters...

Post-traumatic stress disorder is a prolonged experience of stress, anxiety, fear, sadness and other symptoms following a trauma. Post-earthquake PTSD is a condition that can be seen in many people who have been affected by the earthquake.

As humans, we are an extremely resilient species. Since our existence, we have been able to recover from brutal wars, countless disasters (natural or man-made), and violence and betrayal in our own lives. But these traumatic experiences leave scars in our history and culture, large and small, that are passed down through generations. These scars have profound effects on our structural body (our biology and immune system) and our energetic body (our mind, emotions and spiritual system) that we may not realize. These traumas affect not only the trauma survivors but also everyone in their social environment.

Physical and psychological violence, disasters such as earthquakes, floods, wars, loss of a loved one and similar events can cause some mental problems in individuals in relation to trauma. This problem is called Post Traumatic Stress Disorder (PTSD) . It is important for the individual and his/her family, as well as for society, to be able to determine in advance which psychological and physiological reactions are normal after a trauma and which are diseases, and who will recover spontaneously or who will remain ill for a long time. The fact that the number of people affected by natural disasters such as earthquakes and man-made traumatic experiences such as war is expressed in millions shows that the issue is a serious public health problem.

What are the Important Symptoms of PTSD?

• The primary symptom is recalling the event over and over again.
• The person may withdraw from the environment and turn inward.
• The person loses interest in the outside world.
• The moment of trauma may feel as if it is happening right now.
• Avoiding places, people and conversations that remind the trauma event is among the most important symptoms.
• The person may experience a sense of terror.
• Difficulty sleeping, being startled by sounds, quick anger and emotional blunting are among the symptoms.

Approximately 10-15% of the victims recover very soon after a disaster. Approximately 70% of them are affected by the event and show “stress reactions”. All kinds of support and especially psychosocial support activities are very important for people in this group. Whether their “stress reactions” are long or short-lasting is directly proportional to the support they receive. The remaining 10-15% are affected by traumatic events in the long term.

Rehabilitation for the consequences of this earthquake can only be mitigated in a planned manner for the next 10 years. For this, it is necessary to proceed within a plan of the right quality. The solution requires a planned preparation before building buildings as soon as possible. How children will cope with this trauma and how their education should be shaped should not just be about feeding them.

The fear and anxiety after an earthquake is particularly challenging for children. Some children may return to behaviors that were normal at a young age, such as thumb sucking and bedwetting. They may have nightmares and be afraid to sleep alone. Their school performance may be affected. They may also throw tantrums more often or become withdrawn and want to be alone.

Earthquakes have and will have enormous and long-term effects on the people who experience them. It is very important for different branches to act jointly and provide patient-oriented rehabilitation services to solve medical and psychological problems, especially for people who have experienced these traumas in the earthquake region. This must be planned correctly and coordinated under the leadership of people with merit...

This situation that we experience as a whole society, especially in the earthquake geography, is post-traumatic stress disorder. People of all ages can have post-traumatic stress disorder. Especially those who have suffered great losses in their families, who have been under the cave-in for a long time and who are in an effort to extract them and cannot be extracted may develop this disorder.

Post-traumatic reactions can be categorized under four main headings;

1. Physical Reactions:

These normal stress reactions are based on the sympathetic and parasympathetic nervous system. The sympathetic nervous system is activated as soon as danger is perceived. It brings about the necessary changes to prepare the body to escape or fight the danger. Its activity can be listed as acceleration in heartbeat and breathing, sweating, movement in the digestive system, tension in the muscles, fatigue, difficulties in falling asleep. There are also aches and pains in different parts of the body, changes in appetite, nausea and changes in sex drive. After the danger is eliminated, the parasympathetic nervous system is activated. It ensures that the changes caused by the sympathetic system in the body are reversed and body activities return to normal.

All these changes are naturally programmed and this is normal. It is even necessary for survival. In some cases, however, the sympathetic nervous system has to work so intensely and for so long that it becomes difficult for the parasympathetic nervous system to take over and recycle the process. At this point, there are a number of problems that arise due to psychological trauma. According to the General Adaptation Syndrome approach, when faced with a stressful event, the body first goes into an alarm state where attention and all senses are sharpened. Then the body starts to fight against the stressful situation with a resistance phase aimed at reducing the effects of the event. If what is done at this stage does not work, there is a state of exhaustion in the body and tissue destruction or even death occurs. In other words, in the face of ongoing intense stress, in addition to the frequently observed psychological reactions, the body also suffers.

2. Emotional Reactions:

Emotional reactions as a result of stress in the face of a traumatic event are normal if they occur in the first two weeks. Traumatized people may experience intense emotions such as shock, fear, grief, anger, guilt, shame, helplessness, hopelessness, emotional numbness. If these emotions persist and intensify after the first 1-2 weeks, this indicates a possible psychological problem.

3. Cognitive Reactions:

Cognitive reactions to stress are linked to emotional reactions. Cognitive reactions can be caused both by the event itself and by physical and emotional reactions. These reactions are summarized as confusion, absent-mindedness, difficulty in spatial and/or temporal orientation, memory problems and confusion.

4. Interpersonal Reactions:

In cases of extreme stress, it is possible to talk about some symptoms that occur in friendship, spousal and parental relationships at home, at school and/or at work. These changes in relationships are characterized by insecurity, anxiety, increased tendency to conflict, withdrawal, loneliness and feeling rejected. There are also examples of distancing, an increased tendency to be prejudiced and an increased need to control.

As in the recent earthquake disaster, the experience is unbearable and unbearable. We have all experienced and continue to experience it in different dimensions depending on our previous experiences, the environment we are in and the level of support we receive. However, while patients with PTSD try to get the trauma out of their minds, they are also desperately trying to get back to normal.

Patients with PTSD want to forget everything. However, our limbic system, which provides the survival mode, is not sufficient in this regard and an inappropriate sympathetic activity (fight/flight/freeze) emerges in the face of the slightest stress. As a result, the intensely secreted stress hormones lead to excessive and inappropriate emotional and physical sensations, impulsive and aggressive behaviors. People think that they are out of control and damaged in such a way that they cannot return to normal.

The most important biochemical change in patients with PTSD is high cortisol levels. At the moment of trauma, there is an intense discharge with survival mode, but instead of returning to normal quickly, it always remains high. This keeps the patient in a constant survival mode. This results in disruption of the neural connections between the Frontal Cortex (forebrain) - Amygdala - Hypothalamus - Limbic System. Thus, governance shifts from the conscious brain (prefrontal cortex) to the unconscious brain (subcotic) and the brain remains on high alert long after the trauma. As a result, it goes into unconscious mode, reacting on the basis of rough similarities, as opposed to the conscious brain, which is able to choose from complex options. There is a constant conflict between these two brains.

One of the most important findings of nervous system imaging studies of patients with PTSD is that the left half of the brain is inactive at the time of trauma. This explains many inappropriate affect and behavior disorders, such as why we remain silent and inactive in the face of a stimulus that reminds us of the trauma.

After the trauma, the world is perceived with a different nervous system. The survivor's energy is now focused on suppressing the chaos at the expense of participating in the flow of life. The attempt to return to normalcy in the face of intolerable mental and physical reactions can result in a wide range of illnesses, including fibromyalgia, chronic fatigue, attention and concentration disorders, and autoimmune diseases. This shows the importance of holistic treatments in the treatment of these disorders.

Although PTSD is related to the specialty of Psychiatry, we Neural Therapists have a lot of work to do because the condition also causes an imbalance between the sympathetic and parasympathetic nervous system and many symptoms are caused by this imbalance. Neural therapy is a universally accepted, very important, low side effect and effective treatment method for restoring the balance between the sympathetic and parasympathetic nervous system using local anesthetics. A correct diagnosis by a physician specialized in the field of neural therapy, followed by the right choice of treatment, is extremely important for healing PTSD and preventing damage.

Consulting physicians who have received internationally recognized and IFMANT-accepted training in this field will provide optimal benefit.

https://www.noralterapi.com/207/egitmen-kadromuz

 

 

REGULATION MEDICINE AND NEURAL THERAPY APPROACH TO EARTHQUAKE AND RELATED POSTTRAUMATIC STRESS DISORDER (PTSD)

February 06, 2023 Earthquake in Turkey and its Related Post Traumatic Stress Disorder (PTSD) in Regulatory Medicine and Neural Therapy Approach

Neslihan Özkan1,3, Demet Erdoğan2,3, Hüseyin Nazlikul3,4,5

1 Freelance Physician, Bursa, Turkey

2 Freelance Physician, Istanbul, Turkey

3 Scientific Neural Therapy and Regulation Association, Istanbul, Turkey

4 Naturel Sağlık - Natural Health Center, Istanbul, Turkey

5 Internatinal Federation Medical Associations of Neuraltherapy, Meiringen, Switzerland

Turkey is one of the countries in the world with high earthquake risk. The recent earthquakes in our country, especially the major earthquakes centered in Kahramanmaraş Pazarcık Elbistan, have caused many people to lose their lives and many people to experience psychological problems such as post-traumatic stress disorder (PTSD).

Post-traumatic stress disorder is the experience of prolonged stress, anxiety, fear, sadness and other symptoms following a trauma. Post-earthquake PTSD is a condition that can be seen in many people affected by the earthquake.

Symptoms of post-earthquake PTSD can be seen in different ways in people who have experienced the earthquake. Some people may experience anxiety, anger, sadness and depression related to the emergency. Others experience the shock of the event and may experience anxiety, impaired concentration, sleep problems while avoiding remembering traumatic experiences such as reliving the event.

Trauma is when an individual experiences and/or witnesses events that pose a threat to his/her or others' physical integrity, such as death, serious injury or sexual assault. Psychological trauma is defined as a situation that the individual experiences with a severity and intensity far beyond what he/she can cope with, where his/her limits are pushed, and which causes fear and helplessness. Many people may encounter many events that cause them to feel feelings such as fear, sadness, tension, anxiety, helplessness and anger at various periods of their lives. However, very few of these are truly traumatic.

Posttraumatic Stress Disorder (PTSD) is a disorder that occurs after a severe psychological trauma and manifests itself with characteristic symptoms such as repeatedly experiencing the traumatic event, avoidance of stimuli that remind of the event and increased arousal, inability to plan for the future, insomnia, nightmares, alienation. If these symptoms last less than three months, they are called acute PTSD; if they last longer, they are called chronic PTSD. Sometimes symptoms may appear as long as 6 months after the traumatic event. This is called “delayed onset PTSD”.

The nature of the trauma, its severity, previous traumatic events, the meaning that the person attributes to the trauma and the conditions in which the person lives after the trauma are considered to be determinant factors for the emergence of PTSD. For example, many life-threatening traumatic events such as war, physical abuse in childhood, various physical and sexual violence including torture, automobile, train or airplane accidents, natural disasters such as earthquakes and floods, fire, robbery, kidnapping, life-threatening medical diagnoses, terrorist attacks can cause PTSD.

People who develop PTSD are usually in fear and panic. They are extremely sensitive to stimuli and therefore react to even the smallest stimuli. However, apathy, unresponsiveness, lack of pleasure, decreased emotion, helplessness, irritability and outbursts of anger may also be observed. The Posttraumatic Stress Disorder Scale (CAPS) can be used to make a diagnosis, assess symptoms and monitor the effectiveness of treatment.

PTSD negatively affects people's whole life, work, relationships, health and activities of daily living. It is also known to increase the risk of various health problems such as depression, anxiety, substance and alcohol addiction problems, eating disorders, sleep disorders and suicidal thoughts. Therefore, early and effective treatment is of utmost importance.

On May 12, 2008, an earthquake with a magnitude of 8.0 on the Richter scale and a maximum magnitude of 11.0 at the epicenter occurred in the Sichuan Province of China, killing 69,227 people, injuring 374,643 people, leaving 17,923 people missing, and leaving approximately 4.8 million people homeless according to official data. According to a 10-year post-earthquake systematic review, the estimated prevalence rate of PTSD was 62.8% one month after the Wenchuan earthquake, 21.5% to 41.0% one year later, and 11.8% eight years later.

Another meta-analysis of 76,101 earthquake survivors shows that about 1 in 4 earthquake survivors were diagnosed with PTSD. This is therefore remarkable evidence that natural disasters such as earthquakes can have a major impact on the mental health of survivors.

Lack of psychological support in affected areas significantly increases the risk of PTSD among survivors. Studies show that children and adolescents, especially girls, are more vulnerable and should receive help as a priority. The prevalence of PTSD varies between studies according to the methodological characteristics of the studies, and is estimated to be around 3.9% worldwide. It is twice as high in women compared to men (10-12% vs. 5%).

On February 6, 2023, we tragically lost many of our citizens in the aftermath of two consecutive devastating earthquakes, measuring 7.7 and 7.6 on the Richter scale, affecting 11 provinces of our country. Many of our citizens also faced serious trauma, both physical and psychological, as they or their relatives were trapped under the cave-in for a long time. Not only those who actually experienced the earthquake, but also those who witnessed the devastation and suffering caused by this great disaster on television and social media were seriously affected, that is, they were exposed to trauma. Therefore, we all felt and continue to feel feelings of helplessness, sadness, anger, anxiety and fear at the highest level. For this reason, unfortunately, many people have suffered from various disorders, including PTSD. It is also a fact that as a country we need a long period of rehabilitation both economically, socially and medically.

The treatment of those affected by the earthquake should be carried out by professional experts in their field. It is extremely important to explain to people with PTSD that their reactions are normal, that the event is out of their control, that anyone can be affected by this situation and that they should not make an effort to appear strong. It is also necessary to give them permission to experience their grief. It would also be good for them to stay in touch with people who understand and support them, and to be supported in sharing their feelings. On the other hand, for those who do not have serious physical disabilities, finding a job and employment as soon as possible should also be a priority.

Psychological resilience (PD) is a concept that describes a person's protective abilities or behaviors against mental disorders and traumas. This concept is generally defined as “the power to recover”, “the ability to overcome disasters” or “the ability to adapt positively”. Psychological resilience (PD) is innate or acquired in some people. In others, this ability is weak, but studies show that PD can be learned, acquired, developed and even treated.

The treatment of PTSD requires a multidisciplinary approach. From the perspective of Western Medicine, various medical drugs, especially antidepressants, and psychological therapies are used extensively. On the other hand, it is possible to offer more inclusive, effective and permanent solutions to patients with Regulation Medicine and Neural Therapy practices. It is extremely important and necessary to urgently use treatment methods that have proven themselves in terms of effectiveness and reliability in order to treat both physical and various psychological health problems experienced by our citizens who survived the earthquake. Therefore, as Neural Therapy and Regulation Medicine physicians, we have very important duties.

We know that the trauma experienced by earthquake victims has negative effects on the vegetative nervous system (VSS), hormonal system and immune system within the scope of the basic regulation system. The basic regulation system of our body always responds to all stimuli, including psychogenic loads, with autonomic, hormonal and cellular changes. Depending on the individual, the system can compensate for a certain amount of stress. However, the intense emotional overload experienced by the earthquake victims and still ongoing may decompensate the basic regulation system. Thus, increased tone in the VSS and especially in the sympathetic system becomes evident. In this situation, the organism will react excessively to the slightest additional stimulus. The basic regulation system is also in communication with the hormonal system via the VSS. Therefore, it is possible to encounter various symptoms of hormonal dysfunction in patients, as dysregulation of the hypothalamo-pituitary-adrenal (HPA) axis becomes inevitable. Stress load also has a direct negative impact on the cellular immune system and the body becomes more vulnerable to various diseases. In other words, the immune system is also related to the VSS through its basic regulation system. It is also important to remember that trauma-related processes are recorded through the sympathetic nervous system and the hormonal system.

PTSD is expected to develop in survivors of such a major natural disaster that our country has faced, and even in many people who are far away and follow the news in the media every day. The HPA axis and the hypothalamo-hypophyseal-gonadal (HPG) axis, which play an important role in stress response, are closely linked to each other. Suppression of estrogen, a hormone of the HPG axis, causes menstrual irregularities and many related disorders, while suppression of testosterone, which has an anxiolytic effect, causes increased anxiety. While many studies to date have shown that women are more vulnerable to stress, there is also new evidence to suggest the opposite, that women may be more resilient to stress and men may be more prone to develop an anxiety-like response.

One study showed that total triiodothyronine (TT3) and free T3 (sT3) were higher in patients with PTSD compared to healthy controls. It has been suggested that symptoms of hyperarousal in patients with PTSD may be related to increased thyroid hormone levels, along with increased activation of the sympathetic nervous system.

Intense and prolonged experience of various emotions leading to PTSD may cause various dysfunctions in some internal organs. It would not be a surprise if emotions such as helplessness, hopelessness, anger and fear, in particular, manifest as various dysfunctions primarily related to the gallbladder, liver and kidneys. In addition, the effect of prolonged exposure to hunger and thirst under the collapse should not be underestimated. Therefore, a segmental evaluation of the hormonal system and all internal organs is very valuable.

In addition to PTSD, various locomotor system disorders, especially limb amputations due to crush injuries, fractures and exposure to cold, problems with the circulatory system, peripheral nerve injuries and the painful pictures and loss of function caused by them are among the important health problems. It should be kept in mind that all of these pathologies may lead to the formation of interference fields and/or foci.

People with post-earthquake PTSD can overcome this condition with professional help, especially from neural therapists. This may include neural therapy, other therapies, psychological support, medications or other treatments. Preparation before an earthquake can also reduce the risk of PTSD. These preparations can include simple measures such as preparing an emergency kit, making a plan, and communication plans for families.

In conclusion, the earthquakes in Turkey have caused many people to experience psychological problems such as PTSD. However, it is possible to cope with this situation by taking the role and responsibility of people with merit, especially us neural therapists, and by taking measures such as professional help and preparation, the effects of post-earthquake PTSD can be reduced.

In the light of this information, there are body-protective and therapeutic applications for PTSD and other health problems with the Neural Therapy approach. In order to perform an effective treatment, the following questions should be answered after a comprehensive anamnesis and physical examination:

a) Does the patient have vegetative dysfunction (dysotonomia)?

b) At which segmental levels is the dysfunction present?

c) Is hormonal dysfunction present?

d) Which internal organs may be affected and what is their emotional connection and significance?

e) Is there a “zone of interference” preventing response to treatment or recovery?

After this detailed anamnesis-interrogation and examination findings, the main lines of treatment are as follows:

1- Local and Segmental Treatment

a) Finding and treating the affected segments (quaddel, facet injection, etc.)

b) Treatment of myofascial trigger points (including cervical, thoracic, lumbosacral and perineal muscles)

c) Hormonal axis injections (thyroid, tonsilla pharyngea, plexus uterovaginalis/plexus vesicalis, quaddel series in the genital area)

d) Lower extremity circulation protocol

2- Extended Segment (ganglion) injections (especially supremum, stellatum, celiac, sacral canal)

3- Disruptive focus and/or field treatment

Scientific Association for Neural Therapy and Regulation (BNR)

Sources:

 

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